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General Surgery

Upper GI

Achalasia

Achalasia, also known as oesophageal achalasia is a condition in which the oesophagus (a tube that carries food from the mouth to the stomach) is unable to move the food into the stomach. Lower oesophageal sphincter is a ring of muscle fibres that surrounds the lower-most end of the oesophagus where it joins the stomach. LES acts like a valve between the oesophagus and stomach preventing food from moving backward into the oesophagus. In people with achalasia, the LES fails to relax during swallowing resulting in the back up of food.

The main symptoms of achalasia include difficulty swallowing (dysphagia), regurgitation of food, heartburn, weight loss, chest pain, and cough.

Your doctor may order the following tests to diagnose achalasia:

Barium swallow test: The test involves swallowing a barium preparation while X-rays are taken. The barium coats the walls of the oesophagus and stomach and makes the abnormalities visible more clearly.

Endoscopy: This test allows the doctor to examine the inside of the patient’s oesophagus, stomach, and portions of the intestine, with an instrument called an endoscope, a thin flexible lighted tube.

Manometry: It is a test that measures changes in pressures exerted by the oesophageal sphincter.

Treatment options for achalasia include:

  • Medications: Medications such as nitrates and calcium channel blockers are recommended to relax the lower oesophagus sphincter.
  • Botox: Botulinum toxin injection can be administered to help relax the sphincter muscles
  • Balloon dilation (pneumatic dilatation): A small balloon is positioned at the LES and inflated in order to widen the opening for food to enter the stomach.
  • Myotomy: It is a surgical procedure in which the sphincter muscle is cut to allow the oesophagus to open.

Depending on your situation your doctor will decide which treatment is right for you.